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General NPI Number Information
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NPI Number | 1679812796
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Entity Type | Organization
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Legal Business Name | CATHY BOSCHERO, LLC
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 1700 N UNION AVE
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City | ROSWELL
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State | NM
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Zip | 88201-3267
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Country | US
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Telephone | 575-624-2121
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Fax | 575-624-7981
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Provider Business Mailing Address
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Address Line | PO BOX 974
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City | ROSWELL
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State | NM
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Zip | 88202-0974
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Country | US
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Telephone | 575-624-2121
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Fax | 575-624-7981
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. CATHY BOSCHERO
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Credential | CNP
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Telephone | 575-624-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | CNS00056
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R19986
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP00315
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License Number State | NM
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